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The business of medical education

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You would never find advertisements for "confirmed admission" to any IIT or AIIMS or one asking you to book a seat in advance in any of these premier institutes. Neither are there advertisements promising you selection for the civil services or placement in an all-India service of your choice. Yet, the media is full of ads for MBBS seats in colleges across the country.

How, if the system is merit-based, can anyone promise "direct admission"?

Behind this promise is a black market in medical seats in private colleges. With agents and college managements colluding to sell many of the 30,000-plus MBBS and over 9,600 postgraduation seats in private medical colleges, back-of-the-envelope calculations by TOI suggests that about Rs 12,000 crore in hard cash changes hands in this black market every year.

Of the 422 medical colleges in India, 224 are private, accounting for 53% of MBBS seats. Many of these colleges are running with little or no facilities, no patients and fake faculty. The going price for an MBBS seat could range from Rs 1 crore in colleges in Bangalore to Rs 25-35 lakh in some in UP. Seats in MD in radiology and dermatology cost up to Rs 3 crore.

- - -All told, the sale of post-graduate seats alone is estimated to be worth about Rs 2,900 crore. Add the highly valued seats for super-specialisation, about 370 in the private sector, of which again at least 40% is sold, and the post-MBBS education black market figure crosses Rs 3,000 crore. Thus, along with the MBBS seat sale, the total amount comes to about Rs 12,000 crore.

The bulk of the money is paid in cash, leaving no trace of the transaction. And despite the advertisements giving the game away, the government has not cracked down on this black market or taken steps to arrest the rot in the medical education system.

For the full text of the report in the ToI, click here.

Talking about this to a senior doctor friend (in person), who was associated for a while with one such pure business shop, sent me the following list of 'admission' and annual tution fees, which he tells me is an open secret:

MBBS 2016
Karnataka -----
Ramaiah - 1.4 CR full package
Kempegowda - 1.3CR full package
Ambedkar - 75 + fee (4.25/y)
Vydehi - 80 + fee
Mvj - 70 + fee
Rajarajeshwary - 75 + fee
Sapthgirih - 65 + fee
Kbn - 50 + fee
Mrmc - 60 + fee
Al ameen - 55 + fee
Jjm and ssim Dhavangiri  - 65 + fee
(Fee - 4 to 5 / y)
Jss Mysore - 75 + 5.5/yr
Devaraj urs - 50 + 6.6/yr
Blde Bijapur - 45 + 6.5/yr
Kle - 50 + 6/yr
Nitte (ks hugde) - 45 + 6.5/yr
Yenepoya - 32 + 9.4/yr
Sri Siddhartha - 45 + 4.5/yr
Aj shetty - 70 + fee
Father Muller - 60 + fee

Maharashtra -
Dy Patil Mumbai - 35 + 11/yr
Dy Patil Pune - 35 + 9.5/yr
Dy Patil kolhapur - 26 + 8.75/yr
Bharati Pune - 335+ 11/yr
Bharati sangli - 26 + 10.25/yr
MGM Mumbai - 26 + 10/yr
MGM Aurangabad - 23 + 10/yr
Krishna karad - 30 + 8.4/yr
Pravara loni - 30+ 8.6/yr

Datta meghe - 35 + 8.4/yr
Terna - 30+ 4.5/yr (12th 80%)
Acpm dhule - 30+ 5/yr (12th 80%)
Vikhe Patil - 35+ 5.5/yr (12th 80%)
Smbt - 30+ fee

U.P ---
Rama kanpur - 25 + 9.95/yr
Heritage - 26 + 9.36/yr
Muzaffernagar - 26 + 8.6/yr
Teerthanker - 24 + 12.84/yr
Santosh - 35 + fee
Sharda - 35 + fee
Sharda - 35 + fee
Sarswati + 32+ fee
Rammurti - 32+ fee
Rohalkhand - 35+ fee

Uttrakhand ----
Guru ramrai - 40 + fee
Jolly grant - 43 + fee

SGT gurgoan - 35+ fee

C.M Medical College - 35 + 3.8/yr

Rajasthan -----
Geetanjali - 45 + fee
NIMS - 42 + Fee

Ramachandra - 70 + fee
Meenakshi - 65 + fee
SRM - 65 + fee
Vinyaka mission - 45 + fee
Chaitinad - 80 + fee             

Mahatma Gandhi Medical College & Research Institute, Pondicherry

MD Radiology-1.60
MS Orthopedics-1.30
MD Medicine-1.15
MD Paediatric-1.20
MS Gyanic-1.35
MD Dermatology-1.25
MS Surgery-85

Fee-13 Lac per annum
J J M Dhavangiri -
MD Medicine1.55 Pkg
MS Ortho-1.80 Pkg
MD RADIO-2.10 Pkg
MS/MD Dermatology-1.70 Pkg
MD Paediatric-1.50 Pkg

Raja Rajeswari Karnataka-
Medicine-1.50 Pkg
MS Gyno-1.75 Pkg
MS Ortho-1.90 Pkg
MD RADIO -2.20 Pkg
MD Derma-1.70 Pkg
Md Paediatric-1.50 Pkg
MS Opthal-1.30 Pkg
Aadi Chunchun Giri-
Medicine-1.70 Pkg
MS Ortho-1.80 Pkg
MS Gyno-1.80 Pkg
MD Derma-1.80 Pkg
MD Paediatric-1.50 Pkg
MS Surgery-1.40 Pkg
MS Opthal-1.25 Pkg
MD Anaesthesia-85 Pkg
Dy Patil Pune-
MD RADIO-2.40 Pkg
MS Ortho-2.10 Pkg
MS Gyno-1.90 Pkg
MD Medicine-1.30+fee
MD Derma-1.40+fee17
MS Surgery-1.00+fee
Diploma in skin-75+fee

Dy Patil Kolhapur-
MS Ortho-1.60+fee15.50
MD RADIO-1.70+fee
MD Medicine-1.25+fee
MS Gyno-1.35+fee
MD Dermatology-1.30+fee
MD Paediatric-1.10+fee
MS Surgery-80+fee
MD Anaesthesia-40+fee
Bharti Vidyapeth Pune-
Diploma in Skin-75+fee
MS gyno-1.50+fee14
MS ortho-1.70+fee
MS surgery-80+fee
MD medicine-1.35+fee
MD dermatology-1.40+fee
MD paediatric-1.20+fee
MD anaesthesia-45+fee
MS opthal-90+fee

PIMS Loni -
MD RADIOLOGY-1.70+fee13
MS orthopaedic-1.55+fee
MS gyno-1.40+fee
MD medicine-1.30+fee
MD paediatric-1.10+fee
MS opthal-90+fee
MS Orthopaedic -1.60+ fees 14 lakh
MS Surgery-90+Fees 14L
MS ENT- 70+Fees 14L
MS Opthalmology- 90+Fees 14L
MS Gyano-1.50+ fees
MD RADIOLOGY-1. 80+fees
MD paediatric- 1.15+fees
MD MEDICINE- 1.35+ fees
MD Dermatology- 1.35+ fees
MD anaesthesia- 50+fees
DMRD- 1.05+fees 9L
DGO-70+fees 9L
DCH- 65+fees 9L
D.Ortho- 75+Fees 9L

MD Radio - 1.85+ 13.2/yr
MS Ortho - 1.5 + 13.2/yr
MD Paed - 1.35+ 13.2/yr
MD GM. - 1.25+ 13.2/yr
MS Obg. - 1.3 + 13.2/yr
MS Surg. - 1.00 + 13.2/yr
MS Ent. - 0.6 + 13.2/yr
MS Opth - 90 + 13.2/yr
MD Derm - 1.4 + 13.2/yr
MD Anaes - 45. + 13.2/yr
MD Radio - 2.0+ 13/yr
MS Ortho - 1.75+13/yr
MD GM. - 1.75+13/yr
MS Obg. - 1.75+ 13/yr
MD Paed. - 1.4 + 13/yr
MD Derm. - 1.4 + 13/yr
MS Surg. - 1.0 + 13/yr
MS Opth. - 1.0+ 13/yr
MS Ent. - 0.8 + 23/yr
Al-AMEEN , Bijapur
Gen med : 1.35+5/yr
Paed. : 1.45+5/yr
Gynea. : 1.35+5/yr
Surg. : 1.10+5/yr
Ortho. : 1.60+5/yr
Radio. : 1.80+ 5/yr
Ms Ent. : 65+ 5/yr
Dmrd. : 80+ 5/yr
Dgo. : 65 + 5/yr
DA. : 30+ 5/yr
D Ortho. : 45+ 6/yr

MD Radio - 1.80+F 1.55+F
MS Ortho - 1.45+F. 1.35+F
MD GM. - 1.20+F. 1.10+F
MS Obg. - 1.35+F. 1.25+F
MD Derm.- 1.30+F. 1.15+F
MD Paed. -1.20+F. 1.10+F
MS Surg. - 85+F. 80+F
MS Opth. -80+F. 75+F
MS Ent. - 60+F. 50+F
MD TB&Ch-45+F. 40+F
MD Psych- 40+F. 35+F
Booking Started

Fee->7 P/Y

Narayana medical college Nellore
Radiology -2.5
Dermatology -1.7
TB&Chest -1.15
Anasthesia -80
Psychiatry -80
Emergency med-1
Vinayaga mission salem 2016 pg
M.d radiology -1.45--4 seats
M.s ortho -1.4--4 seats
M.d Paediatric -1.3--4 seats
M.d dermatology -1.3--4 seats
M.d general medicine -1.15--5 seats
M.d gynaecology -1.3--4 seats
M.s surgery-70--4 seats
M.d anasthesia -45--4 seats
M.d emergency medicine -60--2 seats
Diploma anasthesia-25--2 seats
Diploma in ophthal -30--1 seat
Diploma in ortho-45--2 seats
Diploma in ent-25--1 seat
**salem main campus..for diploma-8
Meenakshi medical college kanchipuram 2016 pg
M.d radiology -2 seats-1.80
M.d gynaecology -3 seats-1.50
M.s ortho-2 seats-1.80
M.d Paediatric -3 seats-1.40
M.d general medicine-6 seats -1.30
M.s surgery -5 seats -1.20
M.d dermatology -3 seats-1.50
M.d chest medicine-2 seats-1.10
M.s ent- 2 seats-75
M.s opthal-1 seat-80
Left out available seats in India @ top colleges..
DM cardio -90+15 p yr
Reproductive Medicine-90+15 p yr
Neonatology-70+15 p yr
Nephrology-45+15 p yr
Gasterology-50+15 p yr
Neurology- 200+20 p yr
Uro -1.30+20 p yr
Neuro-20+15 p yr
Paediatric - 20+15 p yr
Cardiothoraic-20+15 p yr
Plastic -20+15 p yr


MD anaesthesia - 85
MD dermatology-1.85
MD gen medicine-1.65
MD paediatrics-1.85
MD pathology-75
MD radiology- 3.10
MS OBG - 1.65
MS ophthalmology-1.30
MS ENT- 85
MS gen surgery- 1.55
MS orthopaedics -2.05

Santosh University
TUBERCULOSIS/Pulmonary med-85L
M.S. ENT-80L
D T.B &C-40

And, quite as stated in the report, he says that almost the entire sum other than what is termed as the admission fees is collected in cash, for which of course no official receipts are given. In turn, he too was paid a large part of his salary in bagfuls of cash, which he was mortally afraid of carrying around.

Further, almost all of these business shops are linked to politicians, many of whom are sitting MLA's and MP's, and that's also why there's not even the talk of the need for correction, as yet. Well, for whatever it's worth, let's set off a debate on Praja.

In this connection, the noted columnist, Shekhar Gupta, had tweeted with "TN med students suicides highlight the scandal of almighty Medical Council of India. No govt dares fight it, if a minister does, is fired". To this, I had responded with "I had thought the Modi sarkar was capable of fighting it. But, of course, it can't happen through a Smriti heading HR ministry".

The question further is also of what kind of doctors these pure business shops can produce.

The good doctor also added that there the private colleges like the Kasturba Medical College, Manipal, who compare amongst the best in the country, and whose admission procedures are largely based on all-India merit ranking, and the fees (including admission fees) is paid totally in white.

The sad part is a number of government medical colleges too, particularly the ones set up recently, are upto all kinds of trickery, as debated on in the blog linked here. And, of course, a large section of private engineering colleges too are carrying on a similar game (as debated on in the blog linked here), though perhaps to a slightly lesser extent, since the supply has outgrown the demand.

The actual position however is that there's still a large need for good engineers, and a humungous need for good medical professional of all kinds. As such, if our HRD ministry could get its act together and revamp the existing regulatory bodies, India could very easily become the world resource for quality professionals in all of these fields.

Muralidhar Rao


murali772's picture

long overdue reforms

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In a move that is expected to bring in more transparency in the functioning of Medical Council of India (MCI), the government plans to cap a member's term in the council to a maximum of two terms, each of five years. In other words, a doctor can be member of the MCI for a maximum of 10 years.

The limit would also be applicable for office-bearers such as president and vice-president of MCI, council members and its executive committee members, a senior official in the health ministry said.

The proposal, drafted by the health ministry based on recommendations of an expert committee, is part of a major restructuring plan for MCI. The proposal has been sent to the parliamentary standing committee on health for its suggestions.

- - - The ministry's proposal also suggests raising the qualification threshold for doctors to assume membership of the council. "At present the qualification criteria is very low and anyone who is a MBBS graduate with merely five years of experience can become a member of MCI with nomination from state or constituency," the official said.

- - - The draft restructuring plan also includes classification of MCI into separate verticals based on its three distinct responsibilities — framing norms based on which medical colleges can be set up, inspecting medical colleges and regulating conduct of doctors.

The proposal is likely to give more teeth to Centre, which will have more say while approving decisions of the council, the official said.

For the full text of the report (emphasis added by me) in the ToI, click here.

Long overdue reforms - the only question can be why it took the ministry so long to go about it. Well, better late than never, and one hopes the ministry will push it through the parliamentary procedures fast enough to make for the lost time.

Muralidhar Rao
murali772's picture

welcome judicial intervention

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Saying the Medical Council of India (MCI) had "repeatedly" failed in its duties and the quality of medical education in the country was at its "lowest ebb", the Supreme Court on Monday appointed a high-powered committee headed by former CJI R M Lodha to clean up the system by taking over the functions of MCI.

"The medical graduates lack competence in performing basic health care tasks. Instances of unethical practices continued to grow. The MCI was not able to spearhead any serious reforms in medical education. The MCI neither represented the professional excellence nor its ethos," said Justice A K Sikri, who wrote the judgment for the five-judge Constitution bench comprising justices A R Dave, R K Agrawal, A K Goel and R Banumathi. The system keeps out most meritorious and underprivileged students, the bench said.

- - - The court said deep-rooted corruption is prevalent in MCI and its members, coming from commercialised corporate private hospitals, were also found indulging in unethical practices such as carrying out unnecessary diagnostic tests and surgical procedures to extract money from hapless patients. It said the law needs to be amended as the Centre has no power under the present system to disagree with MCI and give policy directives to the regulatory body.

"The existing system of graduate medical education is required to be re-invented. The admission process was not satisfactory as majority of seats in private medical colleges were being allotted for capitation fee. The system keeps out most meritorious and underprivileged students," the bench said.

For the full text of the report in the ToI, click here.

While courts have been criticised for judicial over-reach, perhaps this is one area where it's seen to be welcome, with government just pussy-footing on the issue.

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